ANZCTR search results

This study aims to find out if a sensory discrimination training method that is effective in reducing sensory impairment in adults who have had a stroke is also effective in reducing impairments in sensation for children with cerebral palsy. We hypothesise that sensory discrimination training will improve sensory discrimination for children with hemiplegic cerebral palsy and result in improvements in function, activity and quality of life. Additionally we hypothesis that central changes will be evident on fMRI following intervention. We hypothesise that changes will be sustained at 6 months post intervention.

Anxiety and depression co-occur highly with each other, with 69% of anxious youth being diagnosed with depression and up to 75% of depressed youth meeting criteria for an anxiety disorder (Angold, Costello, & Erkanli, 1999). When different classes of disorders co-occur at such high rates, selecting an appropriate treatment approach can be challenging. Traditional CBT for anxiety or depression are mostly single-target approaches focusing specifically on either anxiety or depression. Evidence-based interventions for multiple problems required a therapist to prioritise treatment goals and treat one problem at a time (Barlow, Allen, & Choate, 2004). However, this approach risks client drop out before he or she receives essential treatment for co-occurring difficulties (Rohde, 2012). In addition, multiple interventions are often costly to the public health care system (Jacobson, Martell, & Dimidjian, 2001). Given that the high comorbidity rates complicate the conceptualisation and provision of treatment and are generally associated with higher dropout, lower recovery, and poorer maintenance of gains (Rohde, 2012), treatment strategies that are flexible enough to accommodate diverse problems are needed. Recent development in unified treatments suggests that a transdiag-nostic approach appears to be more efficient and effective than treating disorders in a serial manner (Barlow et al., 2004). Unlike most traditional disorder specific treatments, transdiagnostic approaches target common features underlying symptoms in comorbid disorders (Barlow et al., 2004). They are more time-efficient and cost effective, simplifying treatment for both the client and therapist, which could improve the quality of care and satisfy a great need in public health (Rohde, 2012). Recent research (Barlow, et al., 2004) has identified that one of the common features in anxiety and depression is worry, a repetitive negative valanced process that reflects an unsuccessful attempt to prevent the occurrence of negative events or to devise coping strategies in case such events occur. Worry is an essential feature of Generalised Anxiety Disorder (GAD) and is a presenting characteristic across all anxiety disorders and depressive disorders (Starcevic, et al., 2007). Worry is characterised by the repeated experience of thoughts about potential negative events, and reported proneness to worry varies continuously across the normal population (Ruscio, Borkovec, & Ruscio, 2001). According to the most widely recognized model of GAD (Borkovec, Alcaine, & Behar, 2004), worry functions as a cognitive avoidance response, suppressing images and somatic activation and preventing the individual from emotional processing of fear that is important for successful habituation and extinction (Foa, Huppert, & Cahill, 2006). Such avoidance brings initial relief but results in anxiety maintenance. The repetitive negative thoughts involving anticipating future threat in worriers may disrupt the implementation of effective strategies to solve problems, resulting in maintained or exacerbated levels of distress. Resent data has also highlighted the importance of behavioural avoidance in worry such as reassurance seeking, procrastinating, or over-preparing, aimed at reducing distress in the short term but contributing to the long term maintenance of symptoms (Beesdo-Baum et al., 2012). Therefore, an approach targeting such avoidance strategies in worriers is warranted. Drawing from findings by Borkovec and colleagues (2004), Roemer and Orsillo (2005, 2007) argued that cognitive avoidance in worry may be experiential. That is, excessive worriers may be actively and/or automatically avoiding unpleasant internal experiences (thoughts, feelings, or bodily sensations) by focusing on future events and such avoidance is paradoxically associated with increased distress. Accordingly, training in the skill of mindfulness (i.e., paying attention, on purpose, in the present moment in a non-evaluative and expanded way to both internal and external sensations) may help to break this habitual anxious cycle of worry. An acceptance-based behaviour therapy (ABBT) was developed to specifically target the experiential avoidance in people with generalized anxiety disorder (Roemer & Orsillo, 2005; Roemer & Orsillo, 2007). The principles of the ABBT include (1) expanding present-moment awareness, (2) encouraging acceptance (a willingness to have one’s internal responses in order to participate in meaningful experiences) rather than judgment and avoidance of internal experiences, and (3) promoting action in areas of importance to the individual. A recent meta-analysis has revealed that ABBT is effective at reducing worry and that gains are largely maintained at follow-up (Hanrahan, Field, Jones, & Davey, 2013). Further, Hayes, Orsillo, & Roemer (2010) found that both acceptance of internal experiences and engagement in meaningful activities were related to treatment responder’s status at post-treatment and predicted treatment outcome. Specifically, change in acceptance was related to quality of life at post-treatment. Based on these findings, the current study will emphasise the acceptance component and investigate whether such acceptance approach is effective at improving excessive worry in a sample of community populations. Specifically, we investigate the effect of a mindfulness and acceptance-based group therapy (MABGT) for excessive worry by comparing it with a waitlist control.

We will directly target young people with comorbid depression and binge drinking behaviours and, for the first time, evaluate an internet-based psychological treatment program, augmented with peer-driven social networking. This program can easily be translated into primary care, clinical and real world settings for use by young people experiencing these conditions. Via this study, we aim to: (1) Demonstrate that young people, aged 18-30 years, who are experiencing low mood and are binge drinking will engage with web-based treatments that target their multiple problems simultaneously; (2) Demonstrate that young people with these problems will benefit from web-based treatment targeting low mood and binge drinking simultaneously; and (3) Demonstrate the additional benefit of peer-led social influence on engagement and mood and binge drinking outcomes for young people, when offered in conjunction with a web-based treatment for these conditions. We will examine the relative impact of: (a) Monthly online self-assessment (OSA) for 12 months; OSA (b) OSA + 12-months of access to a 4-week. program of web-based intervention for binge drinking and depressed mood (DEpression ALcohol - DEAL); OSA + DEAL (c) OSA + DEAL + 12-months of access to Breathing Space.

There is strong evidence of adverse effects of polypharmacy in older people and of the benefits of deprescribing generally and antipsychotics particularly. Halting Antipsychotic use in Long Term Care (HALT) is a collaboration between consumers, residential aged care providers, staff, general practitioners, pharmacists, the Dementia Behaviour Management Advisory Service (DBMAS), Dementia Training Study Centre (DTSC), and specialists to reduce inappropriate antipsychotic medication use in long-term resident users and correspondingly to reduce complications, rates of decline and mortality without consequently increasing behavioural and psychological symptoms. We aim to demonstrate that HALT is a nationally applicable and sustainable model.

This study aims to evaluate the efficacy of morning bright light therapy for adolescents with Delayed Sleep Phase Disorder, using newly developed portable LED glasses technology. The study also aims to investigate whether morning activity influences adolescents sleep, daytime functioning and cognitive performance.

Coleus forskohlii extract contains the bioactive compound, forskolin. Preliminary studies have shown that forskolin can increase fat metabolism thus reduce fat accumulation in both animals and humans. It has been suggested that forskolin may also suppress appetite thus reduce energy intake and results in weight loss. This study will evaluate the appetite suppressent properties of Coleus forskohlii extract. In addition the effect on central obesity and risk factors of metabolic syndrome will also be investigated.

The purpose of the research is to investigate brain and movement-related biomarkers associated with chronic neck pain, and determine if these can be used to increase the effectiveness of manual therapy and exercise treatment for neck pain. Patients with insidious-onset non-specific neck pain will be compared with healthy age and gender matched control participants at baseline to determine brain and movement-related biomarkers associated with neck pain. Neck pain participants will be randomised to receive 6 sessions of physiotherapy (manual therapy + exercise) with task-specific training or physiotherapy alone. Assessments will occur a baseline, post-treatment (7 weeks form baseline) and 6 months (26 weeks form baseline). Outcome measures are pain (VAS), kinematic biomarkers measured with 3-D motion analysis, cortical biomarkers measured with magnetic resonance imaging (structural imaging, diffusion tensor imaging, resting-state functional MRI, and MR spectroscopy), and clinical measures including spinal stiffness, muscle performance on the deep neck flexor test, pressure pain threshold, cervical range of motion, Neck Disability Index, SF-12, Pain Impact questionnaire, and General Health Questionnaire-28. This pilot study will (1) determine potential cortical and kinematic biomarkers that can be used to develop targeted interventions for neck pain, and (2) determine if physiotherapy (with or without task-specific training) has effects on cortical and kinematic biomarkers and reduces pain.

Background: Diabetes is on the rise, increasing the burden on our health system. Many people are admitted into hospital with poorly managed diabetes and require insulin initiation to improve their health outcomes. This project aims to improve the transition of care from hospital to the home, using an innovative new Transition Diabetes Team. If successful, it would improve the current care provision to this vulnerable population group, reducing costs and improving health outcomes. This model could be replicated at other Australian hospitals, improving health outcomes and reducing costs nation-wide. Aims: To trial the functionality and effectiveness of Transition Diabetes Team, comprising: a credentialed diabetes educator (CDE) and diabetes specialist in commencing insulin in the home versus in the hospital. To compare hospital Length of Stay (LOS), blood-glucose control and patient satisfaction for patients with poorly managed Type 2 Diabetes between patients receiving Transition Diabetes Team care to people who receive Standard Care. Methods: Eligible participants: * Adults greater than 18 years of age * Admitted into Austin Health *Type 2 diabetes * Need to start or change insulin or other injectable therapy post discharge to improve their glycaemic management – necessitating a diabetes educator to provide education prior to discharge to undertake self-management. All who consent will then be randomly allocated to either the standard care group or the Transition Diabetes Team group: Standard care Group: inpatient diabetes educators providing insulin initiation education while the patient is admitted in hospital. Transition Diabetes Team Group: An RDNS credentialled diabetes educator working with an Austin Health Endocrinologist to provide insulin initiation education after the person is discharged from hospital – in their own homes. Data will be collected on demographics, medical history, medications, diabetes management, HbA1c, hospital length of stay and diabetes treatment satisfaction.

The efficacy of proteasome inhibitors (bortezomib, carfilzomib) in reversing or ameliorating renal impairment in myeloma patients has been demonstrated. The response to myeloma therapy can often be better gauged by the reduction in serum free light chains which have a shorter half-life of 3 to 5 hours, as compared with the full immunoglobulin paraprotein. The initial, very early impact on the level of free light chains is therefore likely to be critical in the effectiveness of carfilzomib in reversing renal failure. We aim to assess the effect of carfilzomib therapy on serum free light chains at very early time-points (24 and 48 hours after the day 2 dose and 24 hours after day 9 dose) following dose administration, with the aim of assessing the value of these measurements as a marker of efficacy and, in future trials, the basis on which to modify treatment regime to maximise the improvement in renal function.

Osteoporosis is common in the Australian population and is a disease in which the bones lose minerals such as calcium, more quickly than the body can replace them. As a results, the bones become fragile and brittle, leading to higher risk of fractures and a loss of bone mass. Bisphosphonates are the main drugs used in the treatment of osteoporosis and work by inhibiting bone loss. Bisphosphonates also have additional effects that are not related to preventing bone loss. These additional effects are thought to be due to their action on the immune system (the cells that fight against disease in the body). There is no study to date showing that bisphosphonates are taken up by human immune cells and this study will enable us to examine the impact these medications have on the human immune system.